Definition of Employer Group Health Plan (EGHP) or Employer

150.1 - Definition of Employer Group Health Plan (EGHP) or Employer Plan (Rev. 30, 09-05-03) When used in context of entitlement to Medicare based solely on ESRD, these terms mean any health organization that: • Is paid for by, or contributed to by, an employer; and • Provides medical care, directly or through other methods such as insurance or reimbursement to current or former employees, or to current or former employees and their families. It includes the Federal Employees Health Benefits (FEHB) program. Employees pay all plans, i.e., group health plans under the auspices of an employer that do not receive any contributions from the employer, also meet the definition of EGHP. NOTE: Under this provision, Medicare is secondary to EGHPs, regardless of the number of employees who work for the employer.